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A new CO2 laser technique for the treatment of pediatric hypertrophic burn scars

机译:CO2激光治疗小儿肥厚性烧伤疤痕的新技术

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摘要

Treatment of hypertrophic scars arising as a result of thermal burns in children is still a big problem. The results of the treatment are not satisfactory for patients and parents, and new methods of treatment are still investigated.We present the use of one of the most modern carbon dioxide (CO2) lasers (Lumenis Encore laser equipped with a Synergistic Coagulation and Ablation for Advanced Resurfacing module) in the treatment of hypertrophic scars in children after burns.From March to April of 2013, a group of 47 patients aged 6 to 16 years underwent 57 laser surgery treatments. The average time from accident was 7.5 years. The results of treatment were investigated in 114 areas. The assessed areas were divided into 2 groups: 9-cm2 area 1, where the thickness of the scar measured by physician was the lowest and 9-cm2 area 2, where the thickness of the scar was the biggest. The results were considered on the Vancouver Scar Scale (VSS) independently by the surgeon and by parents 1, 4, and 8 months after the procedure. In addition, ultrasound evaluation of the scar thickness before and after laser procedure was made.VSS total score improved in all areas assessed by both the physician and parents. The biggest change in total VSS score in area 1 in the evaluation of the investigator was obtained at follow-up after the 1st month of treatment (average 7.23 points before and 5.18 points after the 1st month after surgery—a difference of 2.05 points). Scar ratings by parents and the physician did not differ statistically (P < 0.05). In the ultrasound assessment, the improvement was statistically significant, more frequently for both minimum and maximum thickness of the scars (B-mode measures) (P < 0.05).The use of a CO2 laser in the treatment of hypertrophic scars in children is an effective and safe method. The use of a CO2 laser improves the appearance and morphology of scarring assessed using the VSS by both the parents and the physician. The treatment also reduced the thickness of scars evaluated by ultrasound.
机译:儿童热灼伤引起的肥厚性瘢痕的治疗仍然是一个大问题。治疗的结果对于患者和父母都不令人满意,并且仍在研究新的治疗方法。我们介绍了使用一种最现代的二氧化碳(CO2)激光(配备有协同凝结和消融的Lumenis Encore激光) 2013年3月至2013年4月,一组47位6至16岁的患者接受了57例激光手术治疗,用于治疗烧伤后儿童的肥厚性瘢痕。事故平均发生时间为7.5年。在114个地区调查了治疗结果。评估的区域分为2组:9-cm 2 区域1,其中医师测量的疤痕厚度最低,9-cm 2 区域2,疤痕的厚度最大。外科医生以及术后1、4和8个月的父母分别以温哥华疤痕量表(VSS)评估结果。此外,对激光手术前后的疤痕厚度进行超声评估。在医师和父母双方评估的所有领域,VSS总分均得到改善。在研究人员评估中,区域1的总VSS得分最大变化是在治疗第一个月后进行的随访中获得的(手术后第一个月之前平均7.23分,术后第一个月之后平均5.18分,相差2.05分)。父母和医生对疤痕的评分无统计学差异(P <0.05)。在超声评估中,统计学上有显着改善,疤痕的最小和最大厚度均有改善(B模式测量)(P <0.05)。使用CO2激光治疗儿童肥厚性瘢痕是一种有效和安全的方法。使用CO2激光可以改善父母和医生双方使用VSS评估的疤痕的外观和形态。该治疗还减少了超声评估的疤痕厚度。

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